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2014 UDS Manual âDecember 31, 2014 vs. 1.0 OMB Number: 0915-0193, Expiration Date: 02/28/2015 8 Service Category Applicable ICD-9-CM or CPT-4 Code Number of Visits (A) Number of Patients (B) 24a. Seasonal Flu vaccine CPT-4: 90654 â 90662, 90672-90673, 90685-90688 25.Contraceptive management ICD-9: V25.xx26.014 UDS Manual âDecember 31, 2014 vs. 1.0 OMB Number: 0915-0193, Expiration Date: 02/28/2015 19 Reporting Period: January 1, 2013 through December 31, 2013 TABLE 9E â OTHER REVENUES S OURCE A MOUNT (a) BPHC G RANTS (E NTER A MOUNT D RAWN D OWN â C ONSISTENT WITH PMS-272) 1a.